Marika Peckham, Licensed Clinical Social Worker, Apc

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MARIKA PECKHAM, LICENSED CLINICAL SOCIAL WORKER, APC

Practice address

1855 1St Ave Ste 103
San Diego, CA 92101-2650

Phone

(858) 866-9571

Fax

(619) 324-1023

NPI assigned

Oct 5, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marika Peckham, LCSW

Title

Owner

Phone

(858) 866-9571

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570233600000",
    "number": "1912548413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 1ST AVE STE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012650",
            "telephone_number": "858-866-9571",
            "fax_number": "619-324-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 1ST AVE STE 103",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921012650",
            "telephone_number": "858-866-9571",
            "fax_number": "619-324-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIKA PECKHAM, LICENSED CLINICAL SOCIAL WORKER, APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-05",
        "last_updated": "2019-10-05",
        "status": "A",
        "authorized_official_last_name": "PECKHAM",
        "authorized_official_first_name": "MARIKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-866-9571",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.